Heart failure & cardiomyopathiesDiagnostic or prognostic study
Diagnostic Value of Reduced Left Atrial Compliance During Ergometry Exercise in Heart Failure with Preserved Ejection Fraction
- Diagnostic accuracy study
- two protocols
- exercise stress echocardiography
- speckle-tracking echocardiography
Authors' conclusion
Left atrial compliance during exercise demonstrated superior diagnostic ability to exercise E/e' ratio, with incremental diagnostic value over the resting LA compliance.
Study context
- Population
- Patients with chronic dyspnoea: Heart failure with preserved ejection fraction (HFpEF) vs non-cardiac dyspnoea (NCD) controls; HFpEF by HFA-PEFF algorithm (Protocol 1) or exercise right heart catheterization (Protocol 2)Protocol 1: 225 HFpEF, 262 NCD
- Comparison
- Exercise left atrial (LA) compliance vs exercise E/e' ratio for diagnosing HFpEF
- Outcome
- Diagnostic value of exercise LA compliance for HFpEF
Performance
As reported in the abstract
Discrimination of HFpEF from NCD
| Test or model | AUC |
|---|---|
| Exercise LA compliance | 0.87 |
- Exercise LA compliance vs Exercise E/e' ratio: DeLong p = 0.005 — superior diagnostic ability
- Exercise LA compliance AUC p value
- P < 0.0001
Further findings
Incremental diagnostic value over clinical factors (age, hypertension, AF) and resting LA compliance
- χ2 212.4 vs. 166.2
- P < 0.0001
LA reservoir strain and compliance, HFpEF vs NCD
- Decreased in HFpEF at rest; differences further increased during exercise (Protocol 1)
Protocol 2 (exercise right heart catheterization, n = 67: 49 HFpEF, 18 NCD)
- Findings confirmed
Original publication
Diagnostic Value of Reduced Left Atrial Compliance During Ergometry Exercise in Heart Failure with Preserved Ejection Fraction. Eur J Heart Fail. Published 26 April 2023. doi:10.1002/ejhf.2862
Summarised from the published abstract; every number is checked against it